quote:

Originally posted by Aspen Hill Adventures:
What's in your kit?

quote:

Originally posted by crbutler:
FWIW, your 3 antibiotics have a lot of cross coverage and are VERY weak against gram negative organisms.

Amox and metroniadzole cover anaerobic organisms.

Keflex and amox cover non resistant gram positive bacteria. You need something that will cover gram negative bacteria better. Sulfa (TMP-sulfa) or one of the quinolones like cipro.

I'd suggest getting augmentin (has a resistance defeating substance plus amoxicillin) and cipro IF you have no medical problems and are not allergic to them... but if you use both at the same time you will get diarrhea, and might get a bad organism overgrowth (clostridium difficile) colitis.

As to duct tape- it works great for clean cuts as it seals off the cut and with the amount of adhesive, it stays there until it has healed. Duct tape will be worse if you are one of those who has to look at things every day or two because you will retear open your wound. what makes wounds not heal is exposure to dirt/bacteria and moving the cut surfaces that are supposed to be together. Cheap old superglue also works pretty well on skin cuts...if you can get them to glue together.

Your problem with not stitching will be if you have lacerated an underlying muscle, think your abdominal wall... of course if that happens in wilderness AK and you don't have a way to get a message out (or someone to help you there), you can write a "this is the gun that killed the bar that killed me, its a good gun. Good luck" letter with any major bear encounter involving major lacerations.

In a major trauma situation topical ointment antibiotics are useless (as antibiotics). Vaseline for protecting surfaces is just as useful. It belongs in a first aid kit, not a major trauma kit.

I'd also throw in a space blanket or two. Your biggest worry with major trauma that you can treat by yourself will be going into shock.

Of the ABC's of trauma, you can treat circulation issues (kind of) by yourself, but not airway/breathing issues.

The most critical thing for treating major trauma is "don't be alone."

~Ann

quote:

Originally posted by Aspen Hill Adventures:

quote:

Originally posted by crbutler:
FWIW, your 3 antibiotics have a lot of cross coverage and are VERY weak against gram negative organisms.

Amox and metroniadzole cover anaerobic organisms.

Keflex and amox cover non resistant gram positive bacteria. You need something that will cover gram negative bacteria better. Sulfa (TMP-sulfa) or one of the quinolones like cipro.

I'd suggest getting augmentin (has a resistance defeating substance plus amoxicillin) and cipro IF you have no medical problems and are not allergic to them... but if you use both at the same time you will get diarrhea, and might get a bad organism overgrowth (clostridium difficile) colitis.

As to duct tape- it works great for clean cuts as it seals off the cut and with the amount of adhesive, it stays there until it has healed. Duct tape will be worse if you are one of those who has to look at things every day or two because you will retear open your wound. what makes wounds not heal is exposure to dirt/bacteria and moving the cut surfaces that are supposed to be together. Cheap old superglue also works pretty well on skin cuts...if you can get them to glue together.

Your problem with not stitching will be if you have lacerated an underlying muscle, think your abdominal wall... of course if that happens in wilderness AK and you don't have a way to get a message out (or someone to help you there), you can write a "this is the gun that killed the bar that killed me, its a good gun. Good luck" letter with any major bear encounter involving major lacerations.

In a major trauma situation topical ointment antibiotics are useless (as antibiotics). Vaseline for protecting surfaces is just as useful. It belongs in a first aid kit, not a major trauma kit.

I'd also throw in a space blanket or two. Your biggest worry with major trauma that you can treat by yourself will be going into shock.

Of the ABC's of trauma, you can treat circulation issues (kind of) by yourself, but not airway/breathing issues.

The most critical thing for treating major trauma is "don't be alone."

My stepfather (RIP) was a physician. He did some travel as a camp doctor many times in his life. I think mostly to Alaska and Canada. I don't know if he ever had a serious case happen when in camp but I bet a lot of people were glad he was there.

quote:

Originally posted by Mark:
I live in a fairly remote area, and I've been an active EMT for a couple decades now. Here's my thoughts on a trauma kit:

Look at your trauma kit as a "get home bag", all you want it to do is last maybe 24 hours max and most likely just an hour or two. By definition it is trauma only, so things like band aids or burn ointment can be left out. I've found the bulkier your bag is the less likely you are to have it when you need it. Anyway, I have plenty of different bags (and I also don't live anywhere around bears) but here's one that's small and convenient:

First, the only non-trauma-ish item but probably the one most likely to be used in a serious event is a couple of those two-packs of 325 mg aspirin. This isn't for headaches but to be taken in case of chest pain. To put it into perspective let me do a cut and paste:

There were 46 bear attacks in North America between 2000-2017.

Sadly, these 46 attacks resulted in 48 deaths. Data reveals that 19 of the incidents happened in Canada. Moreover, 27 occurred in the US.
Furthermore, black bear attacks statistics show that black bears were involved in 25 incidents, while brown bears were involved in 21.

There were 66 bear attacks in Alaska from 2000–2017.
During this period, bear-human incidents contributed to 68 hospitalizations, as bear attack statistics for Alaska report.
That averages 3.8 admissions every year, while the average rate of bear attack hospitalizations is 8.6 per 10,000 hospitalizations annually.

There were 6 fatal bear attacks in Alaska from 2008–2018.
The data reveals that three of these deaths have happened over just two years.
However, during the period between 2000–2017, there were 10 fatalities from eight unique bear attacks. In addition to this, brown bears caused seven of these fatalities, while black bears caused three.
Furthermore, the data on recent animal attacks on humans shows that one of these incidents included a bear with cubs.
In 50% of the cases, the victims were alone. In the other 50% of attacks, the victims were in groups of two, with one survivor in half of those cases.

Meanwhile:
Every year, about 805,000 Americans have a heart attack, of these:
605,000 are a first heart attack, 200,000 happen to people who have already had a heart attack

So the odds of using those aspirin in an emergency is exponentially greater than bleeding to death.

OK, next items:
Scissors aren't really "essential" but important enough to include and here's one reason: Had a tractor rollover and land on the driver and he was being transported in the back of a pickup to an intersection to meet with ambulance, I was going to the scene separate from the ambulance as that was going to save 10 or so minutes. Truck got to the intersection first and people decided to keep going but of course there's no communication and they actually went a different way from where the route the ambulance was taking and it was the road I was on. I had emergency lights on my vehicle so they pulled over when they saw me, I knew they had left the intersection so it had to be them (plus there were 3 guys in the back waving like crazy) so we stopped in the road and I only have my stuff and no idea where the ambulance is. So first things first, guy is awake & alert and in pain, has a broken bone poking through one pant leg and the same leg his foot had some injury inside his shoe. Bandaged up the exposed bone then removed his shoe by cutting the shoe laces. Now, I tend to keep my knives pretty sharp and I'd JUST sharpened this one the day before, so I cut the laces by sliding my knife under teh lacings and giving the knife a tug and sure enough it zipped through. However, even though it wasn't a hard tug at all it still caused the person immense pain, like a lot of it. Since then I have always and only used scissors to cut any article of clothing and in my opinion you should too. Also, I don't carry expensive EMT shears because you inevitably get body fluids on them from some infectious person (not talking covid but hepatitis or aids or even just a penn resistant bacteria) so it's better to use a cheap set and toss them when they get worn (which is pretty hard to do even with the cheap ones) or yucky. Leatherman makes a folding one called the Raptor which is a pretty cool tool but can't imagine cleaning it all the time. The ones I keep on my person are "PhysiciansCare model #90293" that cost around $10 but I'll grab one of the $2 pairs without hesitation, they work just as good. Around here the air ambulance services give embossed ones out as promo's, if there is any sort of private service provider might not hurt to ask if they have a pair they can give you.

Tourniquets, I carry two as I can see getting both arms or legs crushed (or bitten, recently here had a terrible dog attack where 2 dogs bit a person so bad they could not find any place to take a valid BP). It is also quite important to write the time down when it is applied and here's the main reasons why- when the tourniquet is applied and circulation stops, the blood starts breaking down which causes it to become acidic. To counteract this, sodium bicarbonate is added to the IV when the tourniquet is removed. I've never had to use one so I haven't seen it but apparently the formula for figuring out how much "bicarb" to add to the IV bag is somewhat complex and the time is a huge factor in that. Anyway, some other place gave me a few small sharpie markers so I keep one of those too.

Gloves, I use nitrile instead of latex, they are much more durable. We've moved completely away from latex. However, if you are ever using gloved hands and you tear a glove no matter what it is made of, the best and fastest thing is to just pull a new glove over everything, broken glove and all.

Now I'll talk about gauze, which IMHO is the main workhorse when it comes to stopping bleeding. I'm pretty much a "direct pressure" sort of person, unless it's in a place like an armpit or groin there's not much that a bunch of 4X4 pads can't seal up. I don't carry any non-stick ones, again that should be done in a hospital environment so it doesn't involve me. Now you can get the gauze pads (actually they are usually called sponges) either in boxes or packages, and packages are the way to go since you can open them with one hand which you can't do with plastic packaging. For pads they are pretty much all that I carry. I've never carried quick clot and have never been in a situation where I thought it would work better than what I had on me but I certainly wouldn't criticize anyone who did carry it. I usually carry 4 packs of 10 and a couple packs of 2 so you don't have to open one of the big envelopes if you just need one.

I usually carry 4 of the gauze roller bandages (4" x 4 yards) as they are useful for a lot of things including spacers under the knee when splinting. Mainly you use them for wrapping around the dressings. The ones we have come sealed in packs of 3 so I just carry 2 of those. You can't tear this stuff and it's a PITA to cut with a knife so you use your scissors a lot when bandaging.

We keep elastic wraps on the ambulances, 2" wide, but I don't carry them in my kit but I'd probably carry 4 on me for a trip into Alaska. Also, I hardly ever use the clips when wrapping them, just tuck a couple inches under a wrap and it holds well. Main tendency to watch out for is in the excitement of the moment it's easy to wrap them too tight so keep checking downstream of the wrap and loosen if the limb gets cold, dark, or you can't feel a pulse. Leave toes and finger tips uncovered to monitor circulation.

I also don't carry duct tape, but this stuff called Coban. It is an elastic tape that stretches and sticks only to itself. It's not as supportive as an elastic wrap but it's close. This is what we use when splinting most of the time.

I also carry a roll or two of 1" wide adhesive tape, handy to have and just put an inch on the loose end when you use a roller bandage, and if you have a "sucking chest wound" it's important for taping a dressing with a 1 way valve over the injury.

Anyway, that's my bare minimalist kit. Hope I dodn't sound too long winded!

quote:

Today we went through the pantry + pulled beaucoup cans that were long expired